Drugs & Aging

, Volume 31, Issue 3, pp 225–232 | Cite as

Prevalence and Impact of Fall-Risk-Increasing Drugs, Polypharmacy, and Drug–Drug Interactions in Robust Versus Frail Hospitalised Falls Patients: A Prospective Cohort Study

  • Alexander BennettEmail author
  • Danijela Gnjidic
  • Mark Gillett
  • Peter Carroll
  • Slade Matthews
  • Kristina Johnell
  • Johan Fastbom
  • Sarah Hilmer
Original Research Article



Several measures of medication exposure are associated with adverse outcomes in older people. Exposure to and the clinical outcomes of these measures in robust versus frail older inpatients are not known.


In older robust and frail patients admitted to hospital after a fall, we investigated the prevalence and clinical impact of fall-risk-increasing drugs (FRIDs), total number of medications, and drug–drug interactions (DDIs).


Patients ≥60 years of age admitted with a fall to a tertiary referral teaching hospital in Sydney were recruited and frailty was assessed. Data were collected at admission, discharge, and 2 months after admission.


A total of 204 patients were recruited (mean age 80.5 ± 8.3 years), with 101 robust and 103 frail. On admission, compared with the robust, frail participants had significantly higher mean ± SD number of FRIDs (frail 3.4 ± 2.2 vs. robust 1.6 ± 1.5, P < 0.0001), total number of medications (9.8 ± 4.3 vs. 4.4 ± 3.3, P < 0.0001), and DDI exposure (35 vs. 5 %, P = 0.001). Number of FRIDs on discharge was significantly associated with recurrent falls [odds ratio (OR) 1.7 (95 % confidence interval [CI] 1.3–2.1)], which were most likely to occur with 1.5 FRIDs in the frail and 2.5 FRIDs in the robust. Number of medications on discharge was also associated with recurrent falls [OR 1.2 (1.0–1.3)], but DDIs were not.


Exposure to FRIDs and other measures of high-risk medication exposures is common in older people admitted with falls, especially the frail. Number of FRIDs and to a lesser extent total number of medicines at discharge were associated with recurrent falls.


Functional Decline Medication Exposure Online Electronic Supplementary Material Frail Participant Edmonton Frail Scale 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We gratefully acknowledge and appreciate the Emergency Departments’ Research Volunteers at the Royal North Shore Hospital for their contributions to data collection.


This study was supported by the Geoff and Elaine Penney Ageing Research Unit, Royal North Shore Hospital. Danijela Gnjidic is supported by a National Health and Medical Research Council Early Career Fellowship.

Conflict of interest

The authors declare no conflicts of interest.

Supplementary material

40266_2013_151_MOESM1_ESM.docx (35 kb)
Supplementary material 1 (DOCX 34 kb)


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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Alexander Bennett
    • 1
    • 2
    • 3
    Email author
  • Danijela Gnjidic
    • 1
    • 2
    • 3
    • 5
  • Mark Gillett
    • 1
    • 4
  • Peter Carroll
    • 1
    • 6
  • Slade Matthews
    • 6
  • Kristina Johnell
    • 7
  • Johan Fastbom
    • 7
  • Sarah Hilmer
    • 1
    • 2
    • 3
  1. 1.University of Sydney, Northern Clinical SchoolSydneyAustralia
  2. 2.Royal North Shore Hospital, Clinical Pharmacology and Aged CareSydneyAustralia
  3. 3.Kolling Institute of Medical Research, Ageing and PharmacologySydneyAustralia
  4. 4.Royal North Shore Hospital, Emergency DepartmentSydneyAustralia
  5. 5.University of Sydney, Faculty of PharmacySydneyAustralia
  6. 6.University of Sydney, Pharmacology DepartmentSydneyAustralia
  7. 7.Aging Research Center, Karolinska Institutet and Stockholm UniversityStockholmSweden

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